Worldwide, more than 1.7 million adolescents are living with HIV, including an estimated 320,000 in South Africa. Adolescents and young adults living with HIV (AYLHIV) in sub-Saharan Africa experience poorer health outcomes than adults, including lower adherence to antiretroviral therapy (ART) and virologic suppression. This group is also characterized by high rates of unprotected sex, increasing the risk of adverse sexual health outcomes and onward transmission. Limited research exists on effective programming for improving health outcomes among AYLHIV. The purpose of this study was to identify modifiable factors for interventions while evaluating the effects of a structured support group for AYLHIV in South Africa.

Child and youth care workers (CYCWs) are a crucial and growing component of South Africa’s national response to HIV and AIDS and other problems affecting children and families. CYCWs use the community-centred Isibindi model of care to reach the most vulnerable with key services including psychosocial, health, economic and education support. Understanding how to support retention in the CYCW workforce is vital to programme quality and sustainability.

Effective strategies for HIV prevention among adolescent orphans and vulnerable children (OVC) in South Africa, particularly girls and young women, are critically needed. To date, adolescent-only educational and behavioral interventions have underpinned prevention efforts with mixed success. Addressing a broader array of adolescent risk factors may help to lower HIV prevalence in this priority population. Let’s Talk is a structured adolescent HIV prevention intervention that goes beyond standard knowledge and skills-based programming to address family dynamics and mental health.

Many children in South Africa live outside of parental care, due to orphanhood, parental labour migration, unemployment, and for other reasons. Family members and other adults thus play an important role in providing substitute care. Non-parental caregivers have been found to experience high levels of psychological distress and burden, potentially leading to poor outcomes for children. The present analysis examines whether these and other potential risk factors are associated with caregiver-perpetrated physical aggression towards adolescent girls living outside of parental care in the Free State province.

Early bereavement is common in South Africa, where almost a fifth of children have lost a parent and many more have experienced the death of another family member or friend. However, little is known about young people’s psychological responses to loss in this setting.

Almost one-fifth of children in South Africa have lost a parent; many have experienced multiple losses. Bereaved children are at increased risk for psychological health problems including maladaptive grief and depression. Despite the scale of need, evidence for effective psychological support services is limited.

Children and adolescents affected by HIV are at elevated risk for depression, yet research on related interventions in this population is scarce in sub-Saharan Africa. This study sought to examine the effects of interpersonal psychotherapy for groups (IPTG) on depressive symptomology among orphaned and vulnerable adolescents in South Africa—home to the world’s largest HIV epidemic.

Community-based care and support programmes for orphaned and vulnerable children (OVC) and their families are a critical component of HIV prevention, care and treatment efforts worldwide. Addressing the challenges that confront programme evaluators in these contexts can help promote robust evidence for effective programming.

Home visiting is a popular component of programs for HIV‐affected children in sub‐Saharan Africa. Many programs are staffed by volunteers whose training and compensation is minimal, raising questions about whether investing in paraprofessional workforce development might yield measurable gains in beneficiaries’ well‐being.

Cash transfers for low‐income families are an effective investment in children’s health and well‐being. Identifying ways to increase social grant uptake among orphans and vulnerable children and their families in South Africa is therefore a priority. Home visitors may be particularly well‐positioned to connect families with the highest grants for which they are eligible.

HIV counseling and testing underpin sustainable epidemic control, and international guidelines call for all children in generalized epidemic settings, such as South Africa, to be tested routinely. Identifying effective strategies for expanding pediatric uptake of HIV counseling and testing services is therefore critical.

Adolescent orphans and vulnerable children (OVC) are at heightened risk of HIV infection. Effective preventive strategies are therefore urgently needed. While behavioural interventions are the cornerstone of HIV prevention, psychological interventions may also hold promise as part of a coordinated effort to decrease sexual risk‐taking.

This brief describes the findings and program implications from a study designed to develop critical knowledge on “what works” to improve the well-being of children affected by HIV and AIDS.  Community-based home visiting, in which care workers provide a range of support services during regular visits to the child’s home, is an increasingly popular service delivery approach in South Africa. However, there is enormous variation in how home visiting programs are implemented.  The aim of the study is to evaluate the relative impact on child wellbeing of a range of home visiting models.

Focusing on 13 program sites in KwaZulu-Natal, this report describes the support offered by Isibindi Child and Youth Care Workers (CYCWs) to beneficiary families as well as changes in key measures of children’s wellbeing over a two year period. We further examine differences in the provision of care and support services and changes in wellbeing between beneficiaries at high- and lower-functioning Isibindi sites, according to NACCW’s own site assessment process.

This report concentrates on the physical and emotional maltreatment of orphans and other vulnerable children by adults living in their households. While OVC programs have begun to prioritize child protection interventions, little is known about the prevalence of child maltreatment among the OVC population in South Africa or what factors place children at higher risk.  The findings presented here are drawn from the baseline assessment of a longitudinal study designed to assess the efficacy of a range of interventions for vulnerable children (study methodology and sample characteristics described in greater detail above).

Youth who have been orphaned or otherwise made vulnerable by HIV or AIDS are also at elevated risk for acquiring HIV themselves. Adequate HIV-related knowledge is a critical tool for prevention, and nowhere more so than in the context of a high-prevalence epidemic such as South Africa’s.  Yet, a recent survey found that less than one-third of youth in South Africa had accurate knowledge of HIV.  A particular imperative exists to educate children who are already at increased risk, including those who are socially vulnerable.

Youth who have been orphaned or otherwise made vulnerable by HIV or AIDS are also at elevated risk for acquiring HIV themselves. Adequate HIV-related knowledge is a critical tool for prevention, and nowhere more so than in the context of a high-prevalence epidemic such as South Africa’s.  Yet, a recent survey found that less than one-third of youth in South Africa had accurate knowledge of HIV.  A particular imperative exists to educate children who are already at increased risk, including those who are socially vulnerable.

Living with someone who is chronically ill impacts children’s wellbeing in a number of ways and can exacerbate vulnerability.  Programs for orphans and vulnerable children (OVC) have responded by expanding their enrollment to include children living with sick parents or caregivers, regardless of orphan status. However, relatively little is known about these children’s experiences, and thus about how best to design and implement effective responses. 

This report provides an overview of study methodology and sample characteristics for a study designed to develop critical knowledge on “what works” to improve the well-being of highly vulnerable children (HVC). The study is a longitudinal assessment of several program models — specifically, the National Association of Child Care Workers (NACCW), Heartbeat International, Tswelopele Initiative, Children in Distress Network (CINDI) and their community-based partners — with emphasis on common intervention strategies for providing support to children who have been orphaned or otherwise affected by HIV in South Africa.